Some input on next steps

So, I see my LLMD next week. My insurance refused to fill my azithro rx yesterday, so it's time for another switch-up. My doc is compassionate and very smart, but he's overwhelmed w/patients. Also, unless my request is totally off the wall, he tends to put me on whatever I request. So, I was hoping for some input.

I am still dealing with horrendous psych issues--anxiety and suicidal depression. Intermittent, very sharp headaches. Muscle cramps. Mild knee pain. Intermittent neck pain. Loose stools. Lack of energy. Lack of motivation. Tested positive three times for increasingly higher titres for Babs. Also positive for Erhlichia and Anaplasma. Western blot (not Igenex) showed only 41 positive on Lyme test.

Been on Biaxin, Malarone, Rifampin, Doxy--maybe others, I can't remember. Currently on Azith, Mepron and Cefdenir, pulsing Tindamax on weekends. Have been taking Buhner-recommended CSA or Babs for about 6 months or more. Have tried Artemisinin for several months. Have been taking GSA and Cats Claw, Japanese Knotweed for more than 6 months. Taking Sarsaparilla and Red root, Burbur detox, Kudzu and Cordyceps, Japanese Skullcap. A number of vitamin and mineral supplements. And probiotics. Oh, and GI Sustain for leaky gut, because I appear to be sensitive to about 3/4 of the foods they tested me for. Consequently, I'm pretty much living on smoothies, some fish, some red meat, olives, avocadoes, rice, beets, apples, seeds, nuts (no almonds) and a few other fruits (sensitive to eggs, spinach, lettuce and tomatoes, formerly some of my staples). Just started growing some water Kefir, and I'll give that a try when it's ready. Oh, and I'm taking Cymbalta and a low dose of Zoloft, which seem to be doing s&%t. And Ativan as-needed, which seems to be happening more frequently over the past week.

I was feeling better after 3 weeks of Rifampin, but I asked to be switched to Cefdenir because of conflicts with Mepron. But I wonder if Bartonella isn't the disease that is giving me most of my problems now, and I should maybe go back on Rifampin despite the conflict? I've treated with 1.75 months of Malarone, and 1.25 months of Mepron so far for the Babs, plus more than 6 months of CSA. Maybe it's time to go after Bart now, even though I don't have a positive blood test?

I feel so terrible right now--have NEVER been this low psychologically in my life (I'm 49). Where would you ask the doc to go now if you were me? IV abx? Back on the Rifampin? Another abx to replace the Azithro that the frigging insurance company won't cover, and leave the rest the same? Just bag the whole darned thing and ask to be taken off of everything? I don't know where to go from here, and I'm in no shape psychologically to be making decisions right now, either. Should I eliminate some of the herbs? I'm amazed that my liver seems to be holding out thus far, with all the s%&t I'm asking it to process.

Were my symptoms worse? Hard to say. The chronic diarrhea that I suffered with for most of 20 years is mostly gone. Now I have unformed stools, but go a normal number of times per day with no bloating, pain, etc. When I crashed in August, I couldn't think straight, couldn't process thoughts correctly, etc. That seems to be mostly gone. I had some swelling in my knee that has resolved. The brain swelling happens less frequently. The insomnia is much, much better--sometimes I even sleep through the night. The anxiety and depression come and go in cycles. Last week's episode and what I've been feeling for the past couple of days exceeds anything I've felt EVER--but then I did have an emotional shock when I didn't get that job. Hard to say what's situational and what's caused by the disease processes. My gut feeling says Bartonella is coming to the forefront now that Lyme, Babs, Erhlichia and Anaplasma have been beaten back. In which case I should probably go back on Rifampin even if it does reduce the effectiveness of Mepron. But I don't know for sure...